This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

Tom Mulcair commits $2.6B to support pharmacare plan

CBC News, September 18, 2015

A New Democratic government would use the purchasing power of the federal government to negotiate lower prices for prescription drugs and pass those savings on to the provinces and territories, NDP Leader Tom Mulcair says.

The NDP plans to spend $2.6 billion over the next four years to “work towards a plan to support universal comprehensive public drug coverage for all Canadians,” if it takes the Oct. 19 vote.

The party is not committing to implement full coverage by the end of its first mandate, but Mulcair said he hopes to achieve average savings of 30 per cent in prescription drug costs through bulk buying.

Once in place, the plan would save the provinces and territories up to $3 billion annually.

Health care is a provincial and territorial responsibility, so an NDP government would have to negotiate precise arrangements with the other various governments. It would not have the power to impose a free coverage scheme. Some provinces, however, have been pushing for such a scheme for some time.

We are pleased to present this report, Pharmacare 2020, which is the culmination of many years of research and collaboration involving academics, health professionals, policy-makers, and public interest groups.

The vision is of a public drug plan that follows four policy recommendations:

1. Provide universal coverage of selected medicines at little or no direct cost to patients through Pharmacare.

2. Select and finance medically necessary prescription drugs at a population level without needs-based charges — such as deductibles, coinsurance, or risk-rated premiums — on individuals or other plan sponsors (e.g., businesses).

3. Establish a publicly accountable body to manage Pharmacare, one that integrates the best available data and evidence into decisions concerning drug coverage, drug prescribing, and patient follow-up.

4. Establish Pharmacare as a single-payer system with a publicly accountable management agency to secure the best health outcomes for Canadians from a transparent drug budget.

Canada has been waiting for Pharmacare since the 1960s. The vision is now clear. Thus, the task turns to the art and science of program development and implementation. This will be difficult and will require political leadership and inter-jurisdictional collaboration — but it is not impossible, as Canadian Medicare has shown. This led to our fifth policy recommendation:

5. Fully implement Pharmacare — a public drug plan that is universal, comprehensive, evidence-based, and sustainable — by 2020.

The United States and Canada were following the same health care cost trajectory until Canada established single payer systems in each of their provinces. They elected not to cover pharmaceuticals. The OECD data demonstrate that this omission was a mistake.

The total health expenditure trajectories diverted, with the United States continuing to hold first place and Canada declining to tenth place amongst 34 OECD nations. But in pharmaceutical expenditures, Canada is second of 31 OECD nations, with per capita drug expenditures exceeded only by the United States.

Drug costs have become intolerable – now 17.5% of their health care spending (calculation using the OECD numbers). Although there has long been much interest in establishing a universal drug program in Canada, the efforts have intensified – culminating in the Pharmacare 2020 report prepared by some of Canada’s more gifted policy experts. The report makes a compelling case for establishing a Pharmacare program.

The concept has gained traction. Canada’s New Democratic Party (NDP), led by Tom Mulcair, has now committed to taking major steps toward making Pharmacare a reality. The three major parties – Conservative, NDP, and Liberal – are very close in the projected results for their election to be held October 19. Whether or not NDP wins, at least Pharmacare is now part of the national political discourse in Canada.

And the United States?

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Physicians for a National Health Program's blog serves to facilitate communication among physicians and the public. The views presented on this blog are those of the individual authors and do not necessarily represent the views of PNHP.